Field of the Invention
The present invention relates to devices, and methods of use thereof, for surgical procedures. More particularly, the present invention relates to methods and devices for endoscopic surgical procedures requiring irrigation and suction.
Devices and methods of providing irrigation fluid and suction to a surgical site to irrigate and evacuate the tissue in the area of the surgical procedure are well known in the art. Such devices generally provide a handle member having a switching device for turning on and off the flow of the fluid provided and also for turning on and off the suction provided. Typically, both the suction source and the fluid source are individually connected through an elongated flexible tubular member to a pump or suction source which are positioned adjacent to the surgical site. Typically, the devices communicate with an external pump source to provide the fluid under pressure to the surgical site.
Minimally invasive surgery (MIS) is the art of performing surgical procedures through several small holes in the body, as opposed to open surgery, which involves an incision to expose the entire surgical field. During an MIS procedure, a sterile irrigation solution is used to wash the area to keep the operative field clean and visible. The irrigant is typically provided in sterile plastic disposable bottles or plastic intravenous bags. The suction force is provided by a vacuum that is available through a connection in the operating room wall or is provided by other measures such as a portable suction machine used in small ambulatory surgical sites.
The device used to control the irrigation and suction is called a suction/irrigation tubing set. Generally, this set consists of two lengths of tubing, one to transport the irrigant and the other for suction. The tubes are attached to a small plastic valve that usually controls the irrigation and suction with two buttons that are similar to the valves on a trumpet. Such a valving mechanism is referred to as a trumpet valve. Such trumpet valves are part of tubing kits available from Allegiance Healthcare, Part Number ASC1200, and from Davol, Inc., Part Number 5202730. Another orifice of the device is connected to a probe which is inserted into the body and performs various activities during the surgical procedures.
Irrigating solutions are pumped into the surgical field by a variety of measures. Those measures include pressurized sterile solution bottles, intravenous bags attached to squeezing mechanisms that force the fluid from the bag, and small disposable battery powered pumps that are packaged with each suction/irrigation tubing set. In addition, there are “hybrid” units which are formed of a power unit, that is connected to wall electricity in the operating room and which provides the power for the pumping unit, that is attached to the trumpet valve tubing set and is disposable.
Early irrigating devices included using solution bags that were hung above the surgical area to provide a head pressure that could be used to gently wash the surgical field. Generally, the irrigating fluid needs to be provided with more force than that supplied by simple head pressure on a fluid, and thus, irrigating fluids are provided using pumps. U.S. Pat. No. 5,484,402 to Saravia et al. teaches a self-contained pumping unit that is located adjacent to a source of irrigation and is remote from the valving handpiece device. The pumping unit includes a housing containing an outlet for liquid, a pumping member for pumping irrigation liquid through the outlet, a motor for driving the pumping member and an electric battery assembly for energizing the motor. An elongated tube connects the pumping outlet to the handpiece irrigation liquid inlet for supplying pumped irrigation liquid to the handpiece.
Another battery powered device is disclosed in U.S. Pat. No. 5,807,313 to Delk et al. A battery powered laproscopic and endoscopic irrigator is taught therein. The pumping unit includes an upper portion that connects directly to an irrigation reservoir holding an irrigation solution such as saline. A lower portion of the pump connects to the batteries. The upper portion of the pump includes a pump, a motor and attachments connecting the upper and lower portions. During the manufacturing of the pump, batteries are inserted into the lower portion and the upper portion is connected to the lower portion via clips. The pump is constructed to hang vertically from the irrigation source and to direct the irrigation fluid source downwardly with some force. There is a wire extending through the bottom of the pumping unit connecting the upper portion with the batteries and motor.
A pulsating battery pump is taught in U.S. Pat. No. 5,718,668 to Arnett et al. The handpiece contains a mechanism used to supply irrigant in a pulsating manner to the surgical site. The pump provides a reciprocally driven device for pumping pulses of irrigation liquid through an outlet device, and a powered drive device for reciprocally driving the pump.
Those battery powered pumps require the presence of switch and a wire that runs from the pump to the trumpet valve. Some battery powered pumps require a pressure switch or a manually operated switch and a wire connection between the switch and the pump. Those additional features, such as the switch and wire connection, add to the complexity of the battery powered pump and provide for sites for mechanical failure and difficulty in manufacture. Additionally, operating such a pump may add extra considerations for the surgeon during an operation.
The prior art also provides a vacuum-driven pumping device. In U.S. Pat. No. 5,542,918 to Atkinson, a fluid pump using a trumpet valve and a vacuum-driven pump is described. The pump is operated using a piston arrangement that includes springs. However, one of the disadvantages of this device is the number of parts used makes the device costly. Additionally, the device uses a pistol grip configuration rather than the more acceptable trumpet valve configuration. Also, the device must have pressure controls or it generates too much pressure for the procedures and could be dangerous.
U.S. Pat. No. 4,236,589 to Griffith discloses a vacuum motor, but has no pump which is the subject of the invention of the instant application.
U.S. Pat. No. 4,604,089 to Santangelo et al. discloses a medical irrigation system having a pump. It is stated therein that the pump may be a vacuum pump, but no details of such a pump are given.
Accordingly, what is needed are devices for surgical procedures, such as endoscopic and laparoscopic procedures, that are simple, yet provide both suction and irrigation with pressure provided by a pump that does not need an additional power source. What is also needed are methods of use of such devices to improve surgical procedures.